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Maternal Mental Health During Pregnancy and Postpartum / Maternal and Perinatal Health Interventions · Journal article
American Journal of Perinatology · August 12, 2026
Encouraging direction, but not yet definitive.
This pre-post implementation study demonstrates that a nursing-led workflow integrating universal perinatal depression screening on postpartum day zero substantially increased screening completion (from 25.7% to 95.0%) and social work referrals (from 34.6% to 47.7%) in an urban academic hospital. The intervention was feasible and acceptable to both nurses and patients, but the study does not report whether screening led to treatment initiation, symptom improvement, or patient-level clinical outcomes.
Retrospective pre-post cohort study with implementation process evaluation. All postpartum patients delivering at an urban academic hospital from February through June 2024 (260 pre-intervention, 262 post-intervention).. Intervention: Nursing-led standardized workflow: administration of EDPS to all postpartum patients on postpartum day zero; scores ≥10 prompted social work consult and reproductive psychiatry consult request.. Compared with: Pre-intervention standard care (inpatient screening practice prior to workflow implementation). n = 522. Single urban academic hospital (site not named).
Screening completion increased from 25.7% to 95.0% (67/260 vs. 249/262, p<0.001) Positive EDPS screens rose from 1.5% to 6.8% (1/67 vs. 17/249, p<0.001) Social work referrals increased from 34.6% to 47.7% (90/260 vs. 125/262, p=0.002)
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
This study provides evidence that a scalable nursing-led screening workflow can overcome a major barrier to perinatal depression detection in inpatient settings. Clinicians and hospital administrators should consider that while screening completion and referral rates improved substantially, the source does not report whether patients completed referred appointments, initiated treatment, or experienced symptom improvement—outcomes that would be critical to assess before implementation at scale.
A well-designed pre-post implementation study in a real clinical setting demonstrating substantial improvements in screening completion and referrals, but limited by single-centre design, lack of long-term follow-up, and no clinical outcome data beyond process metrics.
As stated by the source record.
Quoted from the source exactly as published.
This study provides evidence that a scalable nursing-led screening workflow can overcome a major barrier to perinatal depression detection in inpatient settings. Clinicians and hospital administrators should consider that while screening completion and referral rates improved substantially, the source does not report whether patients completed referred appointments, initiated treatment, or experienced symptom improvement—outcomes that would be critical to assess before implementation at scale.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Objective To evaluate whether a nursing-led post-delivery inpatient workflow increased universal perinatal depression screening and improved referrals to behavioral health services. A secondary objective was to evaluate implementation process using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Study Design This retrospective cohort study included all postpartum patients delivering at an urban academic hospital from February through June 2024. We developed a standardized workflow with nursing leadership and reproductive psychiatry, training nurses to administer the Edinburgh Postnatal Depression Scale (EDPS), to all patients on postpartum day zero. Scores ≥10 prompted nurses to place a social work consult and request the obstetric provider to place a reproductive psychiatry consult. Reach and Effectiveness were evaluated using a pre-post study with social work referrals as the primary outcome. Secondary outcomes included EDPS completion rate, screen-positive rate, and psychiatry referrals. Logistic regression was used for adjusted analyses. Adoption was assessed through provider workflow adherence and Implementation was assessed through semi-structured patient interviews and nursing surveys. Results Among 522 postpartum patients (260 pre-intervention and 262 post-intervention), screening completion increased from 25.7% to 95.0% (67/260 vs. 249/262, p<0.001). Positive screens rose from 1.5% to 6.8% (1/67 vs. 17/249, p<0.001). Social work referrals rose from 34.6% to 47.7% (90/260 vs. 125/262, p=0.002). In an adjusted analysis, the intervention remained associated with higher odds of social work referral (aOR 1.56; 95% CI 1.02–2.41, p=0.04). Reproductive psychiatry referrals increased but were not statistically significant. Most nurses reported comfort with the workflow, and patients indicated screening was acceptable and helpful. Conclusion A simple and scalable nursing-led workflow achieved near-universal inpatient perinatal depression screening, improved identification of depressive symptoms, and increased behavioral health referrals. This workflow is feasible, acceptable to nurses and patients, and offers a replicable framework for hospitals seeking to integrate inpatient perinatal depression screening into standard practice
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